PRIMARY HEALTH CARE MANAGEMENT IN BRAZIL – Coordinated Audit (Executive Summary)
With a large population, Brazil has as one of its most difficult and complex missions to ensure universal, equal and free access to health care services, a right enshrined in the Federal Constitution itself. In this regard, the implementation of such public policy is faced with many challenges, as in the case of decentralization of actions, funding sources, the human resources required, and the management of the available financial resources.
Primary health care is the main point of entry into, and the communication hub for the entire health care network; and it should be the preferred contact of the users of the Unified Health System (SUS). At this level of care, the main needs of the population are identified, and that has a bearing on the planning and management of the other tiers.
Primary health care was the subject of this coordinated performance audit conducted by the Federal Court of Accounts (TCU) and by 29 Courts of Accounts (TC), signatories to the Technical Cooperation Agreement entered into on March 25, 2014. The object of this audit was to assess, through a coordinated audit, aspects related to the delivery of services, access, infrastructure and problem-solving capacity of primary health care to citizen-users. More specifically, to define that scope to assess whether primary health care management (at the federal, state and municipal levels) provides quality when delivering services. Therefore, it was considered that quality derives − among other variables − from managerial actions (management processes) implemented for primary health care.
Such auditing encompassed fieldwork − in a spontaneous manner − in 23 states and 317 cities, whose results were added with an electronic survey replied by 14 State Health Departments, 2,577 Municipal Health Departments and 175 Regional Health Management Offices. The audit questions were developed around three big subjects: planning, people management, and monitoring and assessment.
The Executive Summary presents the main results from the audit that was carried out; and constitutes a strategic tool for improving the management of those services, as it offers an excellent diagnosis of the infrastructure, access, delivery of services, and the problem solving capacity of primary health care. The report contains reference to good practices.
Source: https://portal.tcu.gov.br/biblioteca-digital/auditoria-coordenada-na-atencao-basica-a-saude.htm